LIV: Ease through menopause naturally

The natural transition from the reproductive years to the postmenopausal years is not necessarily a smooth one, even though it is a normal process of aging.

No two women’s menopause transition is alike. Some women begin to experience symptoms long before menopause has occurred. This is called “perimenopause” and usually occurs around age 44-47 and can last for four to five years before menopause occurs. Symptoms of perimenopause include menstrual irregularities, hot flashes, vaginal dryness and thinning, decreased libido, mood swings, depression, changes in memory and cognition, sleep disturbances, hair loss on the head, hair growth and acne on the face, fatigue, nausea, palpitations, headaches, urinary tract infections, joint pains, and the beginning stages of osteoporosis and heart disease.

Women rely on the ovaries and adrenal glands to secrete hormones (testostorone and androstenedione-a precursor of estrogen) after menopause. If the ovaries have been removed, then menopause can be a very difficult and sudden transition since there is an immediate drop in hormone production. Also, women with more body fat and muscle tissue generally ease through menopause more gracefully since the fat and muscle tissue help convert the androstenedione (secreted by the adrenal glands) into estrogen.

To determine the hormone levels in the body, naturopathic physicians will measure the amounts in saliva. The saliva test measures the active unbound form of the hormone in the body and determines the levels of estrogen, progesterone, as well as cortisol, testosterone, and DHEA.

Naturopathic treatment involves balancing the hormones through diet, herbal therapies, stress reduction techniques, and bio-identical hormone replacement therapy. It is interesting to note that only 25 percent of Japanese women report experiencing any menopausal symptoms (compared to 85 percent of North American women). This is likely due to their diet which is high in soy. Soy contains “phytoestrogens” which are mild estrogens that bind to estrogen receptors in the human body. Do not be alarmed, men: You will not grow breasts from eating soy!

“Phytoestrogens” will balance the natural estrogen levels in the body: if they are too high, they will reduce them; and if they are too low, they will increase them. Ground flaxseed meal as well as soy from miso paste or soy isoflavone protein powders, are beneficial ways to increase your “phytoestrogens”. Many people do not digest soy in the “unfermented form” (ie commercial soy milk and soy yogurt); but the fermented form (miso soup, tempeh), or fermented soy isoflavone protein powders tend to be easier for the body to digest.

Menopausal symptoms can often be reduced by whole foods diets (avoidance of sugar, white flour, caffeine, and alcohol), stress reduction techniques to optimize the adrenal gland function, and certain vitamins, minerals, and herbs. Vitamins C,E, bioflavonoids and melatonin may help reduce hot flashes.

B vitamins, phosphatidylserine, and GABA may help alleviate anxiety. Iron, biotin, zinc, and selenium can help with hair loss. Herbs such as black cohosh, red clover, and chasteberry are also helpful.

To minimize osteoporosis risk, vitamin D status should be tested and as much as 5000-10 0000 IU/day of Vitamin D can be prescribed. Also, stomach acid levels should be tested since low stomach acid (which often occurs as we age) can inhibit absorption of minerals such as calcium and magnesium. Weight bearing exercises and smoking cessation are also important lifestyle modifications to prevent osteoporosis.

Bio-identical hormones are derived from natural plant sources (ie. soy or wild yam) and are more recognizable to the human body and generally safer then those derived from traditional HRT (horse urine). Bio-identical hormones can be prescribed by a naturopathic doctor in order to balance hormones with fewer side effects. Often, I find that progesterone cream prescribed in minute doses can help reduce the effects of anxiety, insomnia, and depression associated with menopause.

Small amounts of estriol (a safe derivative of estrogen) cream can be applied topically to the vagina to help with dryness or pain during intercourse. These trans-dermal applications of hormones can be prescribed by a naturopathic doctor and obtained by a compounding pharmacist specializing in bio-identical hormones.

It is important to test and monitor hormone levels with a naturopathic doctor while taking these creams.